de Dassel Jessica Langloh, Ralph Anna P, Cass Alan
Charles Darwin University, Ellengowan Dr, Casuarina, Darwin, NT, 0810, Australia.
Menzies School of Health Research, Bld 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, Darwin, NT, 0811, Australia.
BMC Health Serv Res. 2017 Dec 27;17(1):845. doi: 10.1186/s12913-017-2794-y.
Indigenous Australians experience high rates of chronic conditions. It is often asserted Indigenous Australians have low adherence to medication; however there has not been a comprehensive examination of the evidence. This systematic literature review presents data from studies of Indigenous Australians on adherence rates and identifies supporting factors and impediments from the perspective of health professionals and patients.
Search strategies were used to identify literature in electronic databases and websites. The following databases were searched: Scopus, Medline, CINAHL Plus, PsycINFO, Academic Search Premier, Cochrane Library, Trove, Indigenous Health infonet and Grey Lit.org . Articles in English, reporting original data on adherence to long-term, self-administered medicines in Australia's Indigenous populations were included. Data were extracted into a standard template and a quality assessment was undertaken.
Forty-seven articles met inclusion criteria. Varied study methodologies prevented the use of meta-analysis.
health professionals believe adherence is a significant problem for Indigenous Australians; however, adherence rates are rarely measured. Health professionals and patients often reported the same barriers and facilitators, providing a framework for improvement.
There is no evidence that medication adherence amongst Indigenous Australians is lower than for the general population. Nevertheless, the heavy burden of morbidity and mortality faced by Indigenous Australians with chronic conditions could be alleviated by enhancing medication adherence. Some evidence supports strategies to improve adherence, including the use of dose administration aids. This evidence should be used by clinicians when prescribing, and to implement and evaluate programs using standard measures to quantify adherence, to drive improvement in health outcomes.
澳大利亚原住民慢性病发病率很高。人们常称澳大利亚原住民药物依从性低；然而，尚未对相关证据进行全面审查。这项系统性文献综述展示了有关澳大利亚原住民依从率研究的数据，并从医疗专业人员和患者的角度确定了支持因素和障碍。
采用检索策略在电子数据库和网站中识别文献。检索了以下数据库：Scopus、Medline、CINAHL Plus、PsycINFO、学术搜索高级版、Cochrane图书馆、Trove、原住民健康信息网和Grey Lit.org。纳入了以英文撰写、报告澳大利亚原住民长期自我给药药物依从性原始数据的文章。数据被提取到一个标准模板中，并进行了质量评估。
47篇文章符合纳入标准。研究方法各异，无法进行荟萃分析。
医疗专业人员认为依从性是澳大利亚原住民的一个重大问题；然而，依从率很少被测量。医疗专业人员和患者经常报告相同的障碍和促进因素，这为改进提供了一个框架。
没有证据表明澳大利亚原住民的药物依从性低于普通人群。然而，通过提高药物依从性，可以减轻患有慢性病的澳大利亚原住民面临的沉重发病和死亡负担。一些证据支持改善依从性的策略，包括使用剂量给药辅助工具。临床医生在开处方时应使用这些证据，并使用标准措施来量化依从性，以实施和评估项目，从而推动健康结果的改善。
